Medicare HOS Instrument
The Medicare HOS instrument consists of three components: the SF-36® Health Survey; questions for case mix and risk adjustment purposes; and questions added by CMS as required by the 1997 Balanced Budget Act. Physical and mental functioning are measured with the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, which are derived from the SF-36®. If you have any questions, please feel free to contact the Medicare HOS Information and Technical Support Line.
The following Medicare HOS Survey Instruments are available for download:
- 2004 Medicare Health Outcomes Survey Instrument (PDF, 199 KB)
- 2003 Medicare Health Outcomes Survey Instrument (PDF, 701 KB)
- 2002 Medicare Health Outcomes Survey Instrument (PDF, 140 KB)
- 2001 Medicare Health Outcomes Survey Instrument (PDF, 546 KB)
- 2000 Medicare Health Outcomes Survey Instrument (PDF, 46 KB)
- 1999 Medicare Health Outcomes Survey Instrument (PDF, 44 KB)
- 1998 Medicare Health Outcomes Survey Instrument (PDF, 44 KB)
For additional information on the HOS project, please visit the Medicare HOS Overview section, which reviews the survey instrument, as well as the project history and timelines.
Return to the HOS Homepage.
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